Summary
Overview
Work History
Education
Skills
Certification
Additional Information
Timeline
Generic

TANESHA KENNEDY

Austin

Summary

Results-driven Quality Analyst with a proven track record at United Healthcare, enhancing HEDIS measure rates by 20% through meticulous EMR audits. Proficient in risk adjustment protocols and skilled in training clinical staff, ensuring compliance with HIPAA and NCQA standards while fostering effective communication between providers and administrative teams.

Overview

13
13
years of professional experience
1
1
Certification

Work History

Quality Analyst

United Healthcare
01.2021 - Current
  • Company Overview: Equity Staffing Solutions- Remote
  • Conducted EMR reviews for Medicare Advantage populations, identifying missed or incorrect coding related to risk adjustment.
  • Assisted in the submission and review of claims and billing documentation for compliance with care quality standards.
  • Maintained knowledge of payer-specific quality metrics and coding guidelines, aiding in correct data capture.
  • Served as a liaison between providers and administrative teams for chart review clarification and documentation best practices.
  • Ensured compliance with HIPAA and NCQA standards across platforms
  • Equity Staffing Solutions- Remote

Quality Care Analyst

Cigna Healthcare
Oakland
05.2019 - 01.2021
  • Company Overview: Oakland, CA- Remote
  • Improved HEDIS measure rates by 20% through EMR audits and payer data submissions
  • Audited supplemental clinical data for NCQA/CMS compliance
  • Trained clinical staff on HEDIS specifications
  • Conducted EMR reviews for Medicare Advantage populations, identifying missed or incorrect coding related to risk adjustment.
  • Ensured compliance with HIPAA and NCQA standards across platforms
  • Oakland, CA- Remote

Medical Records Reviewer

Maxim Healthcare
Pittsburg
06.2016 - 04.2019
  • Company Overview: Pittsburg, PA -Remote
  • Ensured compliance with HIPAA and NCQA standards across platforms
  • Traveled to numerous medical facilities around Southern California auditing, collecting and reviewing EHR's
  • Supported claims review and quality compliance tracking
  • Acted as provider liaison for chart documentation standards and best practices
  • Pittsburg, PA -Remote

Medical Records Technician

Change Healthcare
Alpharetta
08.2012 - 04.2019
  • Company Overview: Alpharetta, GA
  • Ensured compliance with HIPAA and NCQA standards across platforms
  • Traveled to numerous medical facilities around Southern California auditing, collecting and reviewing EHR's
  • Supported claims review and quality compliance tracking
  • Acted as provider liaison for chart documentation standards and best practices
  • Alpharetta, GA

Education

Bachelor of Science - Healthcare Administration

Devry University
Long Beach, CA
06.2011

Skills

  • HEDIS audits and documentation
  • CMS STARS measures compliance
  • Electronic medical records management
  • HIPAA regulations
  • JCAHO standards
  • Risk adjustment protocols
  • Clinical staff training
  • Microsoft Office proficiency
  • EMR systems expertise
  • Health plan payer portals
  • Quality assurance reporting tools

Certification

Medicare Advocate Certification, 11/24

Additional Information

Available Monday–Friday, 8 AM to 5 PM MST - Remote preferred, Known for reliability, Attention to detail, Strong team collaboration, Willing to assist with additional responsibilities to support organizational goals

Timeline

Quality Analyst

United Healthcare
01.2021 - Current

Quality Care Analyst

Cigna Healthcare
05.2019 - 01.2021

Medical Records Reviewer

Maxim Healthcare
06.2016 - 04.2019

Medical Records Technician

Change Healthcare
08.2012 - 04.2019

Bachelor of Science - Healthcare Administration

Devry University

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